The period corresponding to Marine Isotope Stages 9 (MIS 9) offers the opportunity to study orbital and suborbital scale climate variability under boundary conditions different from those of better studied intervals such as the Holocene and the Last Interglacial. Yet, it is poorly represented in independently-dated continental archives around the Mediterranean Region. Here, we present a speleothem stable isotope record (delta O-18 and C-813) from the Former Yugoslavian Republic of Macedonia (F.Y.R.O.M., southern Balkans), which consists of two periods of growth broadly covering the ca. 332 to 292 ka and the ca. 264 to 248 ka intervals (MIS 9e-b and late MIS 8). We interpret the speleothem delta O-18 as mostly related to regional hydrology, with variations that can be interpreted as due to changes in rainfall amount, with higher/lower values associated to drier/wetter condition. This interpretation is corroborated by a change in mineralogical composition between aragonite and calcite at ca. 328 ka, which marks increasing precipitation at the onset of MIS 9 and occurs within a trend of decreasing delta O-18 values. Also the comparison with the multiproxy climate record available from the nearby Lake Ohrid seems to support the proposed interpretation. The MIS 9e interglacial appears to be characterized by wettest conditions between ca. 326 and 321 ka, i.e. lasting ca. 5 kyr. Decreasing precipitation and enhanced millennial scale variability matches the glacial inception (MIS9 d to b), with drier events at ca. 319 ka (ca. 2 kyr long) and 310 ka (ca. 1 kyr long), and a major rainfall reduction between 306 and 298 ka. The latter is followed by a prominent wetter period between 298 and 295 ka, for which carbon data values suggest high infiltration rate. Rainfall decreases again after 295 ka, and remain low until the growth interruption at ca. 292 ka. Resumption of the growth and progressive soil development, expressed by the carbon isotope record, occurred during the late part of MIS 8. Despite the rather high temporal uncertainty (average 6 ka), the speleothem hydrological record complements the environmental information provided by the Lake Ohrid record and also fits well to the framework of regional and extra-regional variability, showing similarities with pollen records from southern and western Europe, both at orbital and at sub-orbital time scale.